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Evaluating Localization Algorithms for Outflow Tract Premature Ventricular Complexes in Patients Performed Ablation Therapy- Insights from a Single-Center Study
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  • Ali Sezgin,
  • Cem Coteli,
  • Ahmet Kivrak,
  • Ugur Canpolat,
  • Necla Ozer,
  • Hikmet Yorgun,
  • Kudret Aytemir,
  • Hakan Ates
Ali Sezgin
TC Saglik Bakanligi Ankara Etlik Sehir Hastanesi

Corresponding Author:ali_sezgin_666@hotmail.com

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Cem Coteli
Hacettepe Universitesi Tip Fakultesi
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Ahmet Kivrak
Hacettepe Universitesi Tip Fakultesi
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Ugur Canpolat
Hacettepe Universitesi Tip Fakultesi
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Necla Ozer
Hacettepe Universitesi Tip Fakultesi
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Hikmet Yorgun
Hacettepe Universitesi Tip Fakultesi
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Kudret Aytemir
Hacettepe Universitesi Tip Fakultesi
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Hakan Ates
Hacettepe Universitesi Tip Fakultesi
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Abstract

Introduction: Numerous algorithms have been published to estimate the origin of Premature Ventricular Complexes PVCs from the outflow tract, and many studies have compared them. However, a clear consensus on the best algorithm has not yet been established. We aim to assess and compare algorithms for locating the origin of Premature Ventricular Complexes (PVCs) in ECG recordings from patients undergoing outflow tract PVC ablation. Methods and Results: We analyzed ECG records from 116 patients who underwent successful PVC ablation from the outflow tract between June 1st, 2015, and June 30th, 2020. Of these patients, 53 had PVCs originating from the right ventricular outflow tract (RVOT), and 63 had PVCs originating from the left ventricular outflow tract (LVOT). R wave amplitude index in V1 combined with R wave deflection interval in V3, V2 transition ratio, V2S/V3R index, Transition Zone (TZ) İndex, Combined TZ and V2S/V3R index, S and R wave difference in V1 and V2 and R wave duration index and R/S wave amplitude index algorithms and their components were analyzed. The Combined TZ Index algorithm had the maximum sensitivity and negative predictive value, which were 90.48% and 85.37%, respectively. The R Wave Duration Index and R/S Amplitude Index algorithms had the highest specificity and positive predictive value, which were assessed at 98.11% and 94.74%, respectively. With the logistic regression analysis method, the “Y=8.436 – 2.036 x PVC TZ score- 0.06 x PVC V2 R wave duration + 4.661 x PVC V3 R wave amplitude - 1.958 x PVC V2 S wave amplitude” algorithm was created. In this algorithm, the value of the “Y” variable was accepted as >0.5 for LVOT. Conclusion: The Combined TZ Index algorithm had the maximum sensitivity and negative predictive value and the R Wave Duration Index and R/S Amplitude Index algorithms had the highest specificity and positive predictive value in our population (85.71%, 85.37%, 92.45%, 89.47% respectively). “Y=8.436 – 2.036 x PVC TZ score- 0.06 x PVC V2 R wave duration + 4.661 x PVC V3 R wave amplitude - 1.958 x PVC V2 S wave amplitude” algorithm predicts LVOT if Y>0.5.
08 Feb 2025Submitted to Journal of Cardiovascular Electrophysiology
10 Feb 2025Submission Checks Completed
10 Feb 2025Assigned to Editor
10 Feb 2025Review(s) Completed, Editorial Evaluation Pending
16 Feb 2025Reviewer(s) Assigned